InMindOut Blog

I have been watching the recovery of the Floridian building collapse with great sadness.  It reminds me so much of  April 1995 in Oklahoma City. I was in Oklahoma City during the time of the bombing of the Alfred P. Murrah building.  A friend of mine was a police officer and a first responder to the tragedy.  He told me of other first responders who continued to have a hard time with what they witnessed and were later diagnosed with Post Traumatic Stress Disorder.

     One of the first understanding of PTSD came out of World War One when soldiers were diagnosed with “shellshock” after experiencing on going anxiety reactions to the trauma of war.  The trauma would come back to the soldiers in the form of a nightmare of flash back.  The anxiety reactions interfered with relationship and work and the day to day of life.

   Humans react to life threatening experiences (i.e. surviving war combat, or a sexual assault) with fight, flight or freeze.  Scientist have discovered that severe experiences of trauma and or long-term exposure to trauma can change brain chemistry and this in turn can contribute to port-traumatic stress. People who have survived a traumatic event which has been outside of their control and are experiencing emotional problems could be experiencing PTSD.   

    We all react to trauma differently and everyone processes the events of trauma differently. If emotional reactions continue beyond a month, then it is important to look at the symptoms and see if they point to PTSD. Does the trauma keep coming back in the form of nightmares or flashbacks or images?  Are you easily startled or have a hard time sleeping? Are you feeling numb or detached? Are you having a hard time falling asleep or easily angered? Are you having problems with relationships and or work; functioning in daily life? The individual symptoms do not stand alone as indicators of PTSD but may be a sign it is time to talk with a mental health professional about how the trauma is still affecting you.

   PTSD can be treated with therapy and medication.  EMDR (Eye Movement Desensitization and Reprocessing) is a kind of psychotherapy that has been successful in treating PTSD.  Utilizing “bilateral stimulation” EMDR helps a person process the trauma instead of being stuck in reliving it.

   Recovery from PTSD can happen.  When clients can talk about the trauma with out feeling very up set or numb and are able to feel safe and are able to function better in day-to-day life, then the client is on the road of recovery.

As a therapist, there are times when I have to inform a parent that their child has been the victim of a traumatic event. The reactions that come up in the session room can range from angry to completely devastated that their child has been hurt. Also, depending on the trauma, many parents may find themselves in a situation where they are at a complete loss of what to do or even what to say. So many questions come up. How did this happen? Why my child? How can I take away their pain? Will we ever go back to the way things were?

This brings to mind a very important question, how do we help our children recover from trauma? What are some things to keep in mind? Below I’ve written some tips for parents who are struggling with helping their child recover from trauma.

1. Don’t blame yourself for the trauma if you are not responsible for it. Many parents will blame themselves for a trauma that was caused by an extended family member or by someone outside of the family. Blaming yourself for what happened is not productive and only makes you sink lower into a depressive state. It is important to put the responsibility for the trauma in the hands of the person or thing that perpetrated it.

1. Do not deviate from routine if you can help it. Many times parents’ first instinct when it comes to trauma is to deviate from routine and rules in order to “give the child time to heal.” This does not help. Many children who experience trauma prefer to have things go back to the way that they were before all the trauma occurred. This gives them a sense that things are still “normal” between them and their parents. That doesn’t mean that some rules don’t need to change at all. In fact, some rules may need to change in order to accommodate a change that resulted from the trauma itself. If this happens, then it is important to at least talk to the child who went through the trauma to see what changes might need to made in order to help them feel safe.

1. Continue to see your child as your child. Many parents tend to be afraid of how to communicate with their child as well as how to treat them after they have been victimized. At the end of the day, your child is still your child. This means that the very core of who they are has not changed. They are still the same little one that you love and that is a part of you. Keep this in mind as you help them recover. They may not be the same as they were before because of the trauma, but they can grow stronger as result of you being who you are to them.

1. Build a mindset of recovery in your child. The temptation of many people who endure trauma is to be stuck in the mindset of a victim. This mindset does not lend itself towards recovery. Instead, focusing on seeing your child as a survivor and an over-comer can help them recover from what happened. While they will not forget about what happened, they can overcome the past and press forward with their future.

A traumatic experience is a horrible situation for anyone. It can be hard for anyone, child or adult, to recover from but it is not impossible. The important thing for any parent whose child has suffered from trauma is to be there and be present for them.

Hello! Hola! Bienvenidos! The Latinx community form the largest minority group in the United States. This trend is expected to continue with the number of immigrants seeking asylum in our country. We use the term “Latinx” as a gender-neutral term for anyone of Latin-American decent. Did you know that only one third of individuals with mental illness in the Latinx community receive treatment each year which is below the U.S. average by 10%?

What Prevents this population from Seeking Treatment?

Barriers to seeking counseling include cultural beliefs surrounding mental health. The cultural stigma around mental health issues as well as the lack of financial resources, transportation or health insurance, language barriers, and accessibility issues. During challenging times Latinx individuals turn to religion or homemade remedies to cope. Faith and spirituality play a big role in the coping skills which are important but can lack the effective interventions and treatments for mental health conditions. There is a great fear of being labeled as “crazy” which causes Latinos to identify symptoms of depression and anxiety in terms of physical health and issues leading to misdiagnosis.

How Can We Overcome these Mental Health Disparities?

We can work on advocating and breaking the mental health stigma. Acknowledging these specific challenges of the Latinx community. Telling our stories and educating Latinos about mental health and offering resources as needed. As a clinician we can work on increasing our cultural competence. Being aware of the language that may be stigmatizing, such as terms “crazy,” “lazy,” or “loco/loca.” A strength of this population is the strong family networks so encouraging family involvement can help reduce the stigma.

In conclusion, the mental health stigma is an issue globally but especially in Latinx communities. If you or someone you know is affected by mental health stigma, consider addressing it with a close friend, family member and seek help from culturally competent mental health professionals.

Military families come in all shapes, sizes, and many cultural backgrounds. The main commonality is the idea that they have someone that they love who serves and protects our country. This of course brings a whole new dynamic to these families as a whole. As I wrote in my previous piece, the military lifestyle is full of different challenges that these families must face on a regular basis. It is important to note that these challenges cause each military family to develop their own strengths.

What are some of the strengths of these family units? Military families can have a strong sense of unity when it comes to working together and creating a working family system. This can come from the fact that the lifestyle itself comes with a regular amount of change (i.e. moving, deployments, etc.). Because these families often move to a place where there is not a consistent support system established, they often have to rely on each other to feel secure and adapt to a new environment. This does depend, however, on the family itself.

Second, military families have a strong sense of adaptability. As I mentioned before, change is common in the military lifestyle. This leads to consistent changes in the environment, and to many family members having to find new ways to cope with each change.

Third, there is a strong sense of independence in military families. The military culture is steeped in independence as well as a strong sense of constantly moving forward. This of course, impacts the family by causing them to not always reach out and ask for help if that is not necessary. This can often lead to a strong sense of personal responsibility and proactive behaviors.

Fourth, military families are open to trying new things and exploring new cultures. Many military families are stationed overseas in different countries, which can expose them to different ideologies and people. Even living on a military base can lead to a new cultural exposure in some way. Many military children make friends with children from different backgrounds due to where they live and where they might go to school. As a result, military children can be very open and friendly with other people from different backgrounds. Even after the service member retires, the family tends to be open to exploring new things in their community.

Every family has their own set of strengths. Military families are no exception. It is important to see how we can focus on those strengths and encourage their growth.

I’m sure that we’ve seen these clips before. We’ve seen the clips where military family members run to greet the service member who has just come home from a long deployment. From a civilian point of view, it is hard to understand why these family members get so excited at seeing their loved one come home. After all, it’s just a job right? If you really delve into the military culture, however, you will find that their lives are more than just their job. It’s an entire lifestyle that is very different from most of the country. In order to really understand military culture, you have to understand the challenges that many families in the military face.  

First, it’s not just the airman, the soldier, the sailor, or the marine that serves. The entire family serves right along with them. What does that mean you may ask? Military family members often have to give up something in order to support their loved one in the service. This may come in the form of a military spouse putting their career aside due to the frequent moves. Other forms of it may be that the immediate family unit is separated from extended family members, thus not having extra support around when deployments come. Even the children have to give up a set of friends and a school whenever it comes time to move.

Second, the military lifestyle is all about frequent change. A military family may stay in a duty station for at least 2-3 years, four if they’re lucky. This means that spouses have to quit and find new jobs, kids have to go to a different school with different friends, and the family also has to find a new house to live in. Additionally, there is the change that comes with the service member’s inevitable deployments. This forces the family to learn how to adapt to new environments fairly quickly.

Third, deployments are not easy paths to navigate. All military children are faced with the deployment of a family member at some point during this service stint. Some children are able to adapt and able to cope with their mom, dad, or both parents being gone for long lengths of time. While other children have a very hard time with accepting that their parent has to go. Many children ask the questions, “Why does my mommy or daddy have to go? Why can’t they be at my ballet recital? Why can’t they see me at my game? Why do they have to miss celebrating major holidays with us?” There are no easy answers to these questions. Military spouses often have to take up the mantle of maintaining both roles as parents to their children while the other spouse is deployed. This means that one parent is responsible for the care and discipline of the children, most of the time without consistent support. There is also the additional stress of maintaining the household and making sure that everything is taken care of while the service member is deployed.

Fourth, many military families may struggle with adjusting to civilian life after the service member retires or is discharged for some reason. This can come in the form of not being able to find stable employment, dealing with the after affects of PTSD, or even learning how to live with the service member again in the home after them being gone for so long. There is also the added stress of many military service members coming home with serious physical injuries due to combat.

Now that we understand the challenges of military families, how can we as a community provide them with support?

1. Be welcoming to military families in your community. Many families move to communities and often feel like the outsiders. Knowing that there are people that will welcome them into their inner circle, often gives military families a huge bolster of support. This is a huge component when it comes to coping with deployments. 

2. Be attentive to practical needs in military families. Military spouses are the main person that has to keep the “home front” up and running while the service member is deployed. This can be very overwhelming to a spouse who is new to a certain duty station and does not know where resources are. If you know of a military family that could use a little bit of extra help locating resources, then reach out to them and see what it is that they need.

3. If you know of a military family who is getting ready to go through a deployment, reach out to them and see if you can’t be part of their support system. Military spouses can often feel isolated and alone without the service member there with them. Having a strong network of friends and family who can help them if they need it can provide a sense of reassurance and make coping with the separation a little easier.

4. Recognize and respect the service and sacrifice of our military personnel. Many military service members come back home with significant injuries or combat related stress. Many military family members have the difficult task of getting their loved one back to health, and that journey tends to be a very long and arduous one. Many military veterans or active duty personnel tend to go throughout life without even hearing a “thank you” from the people that they fought to protect. If you have the opportunity to meet veterans or active duty personnel, please take the time to thank them for their service. 

Military families make up a very unique part of our society here in the United States. It is important that we recognize the differences, but also the common factors that make them just like us. At the end of the day, they are families that live a different lifestyle, but they still need love and support just like any other family.

When I was working with college students at a busy University, we were sponsoring a program for young people on leadership skills.  During the program one young man seemed to get agitated and then started having a panic attack.  His girlfriend got him outside the program area to the lobby. I met them there and took them to my office.  While his girlfriend went to look for a paper bag, I had the young man breathe with me and to listen to my voice and do what I ask him to do.  Just as his girlfriend came back with the paper bag, he was breathing in a regular rhythm, and his body was becoming to calm.  He and his girlfriend stayed for a while and we processed what had happened. 

   From this insistence, I began to appreciate how deep breathing can really help calm stress. The breath is linked to both the sympathetic and parasympathetic nervous systems. The breath reflects when we are in high stress and when we are calm and relaxed.  Our deep breathing can affect our heart rate.  There is something called the vagal nerve that wraps around your internal organs that can affect heart rate and digestive functioning.  The deep breathing activates the vagal nerve which then lowers the heart rate which in turns calms the body. Deep breathing is just one specific way to calm your body when stressed.

    I find clients with high anxiety often report their minds are racing.  These clients often report that they try the deep breathing but then the think about if they are doing it right or trying to check and see if it is working and end up getting agitated about trying the deep breathing.  With these clients I ask them to think of a word or phrase for the inhale and for the exhale, i.e. I breathe in peace and I exhale stress.  I ask the client to think the phrase for each inhale and exhale as they are doing it.  I might also ask the client to count a 3 or 4 breath, i.e., Inhale to count for count of three, hold for a count of three and   exhales to a count of three.  I find some clients need to engage and slow down their mind for deep breathing to work.

    Utilizing grounding exercise with deep breathing has helped some clients feels calmer before a test or before work.  I ask the clients to be seated in a chair with a back. I ask the client to put their feet flat on the ground, to feel the chair with their bask and to place their hands palms down on their thighs.  Then I ask the client to take four deep breaths.  I ask them to pay attention to the intake and exhale of the breath. While breathing in say, “I breathe in safety and peace.” and when breathing out to say, “I breath out anxiety.”

  The self-calming techniques can really help when you feel stressed out.  As the song goes, “Breathe…just breathe.”

• Michelle Goodwin, LPC